I have done a lot of thinking in the months since I left Treatment about the whole addiction rehabilitation system, especially since I have struggled to maintain continuous sobriety.

Let me be clear that sobriety is my responsibility and mine alone, and the accountability for maintaining it both rests and ends with me.  What follows is therefore not a nicely articulated rant of blame about why my Treatment Centre sucks.  Let me also be clear that I have much to be grateful for about my experience there, and will remain forever so.  There were a thousand small kindnesses, from the counsellors who occasionally snuck diet pepsi onto the property to satisfy my desperate cravings, to private chats in the kitchen or on the back porch with one of the counsellors, to an encouraging wink or pat on the back about my progress.  These did as much to soothe and heal as did the hard work of therapy, guided by skilled practitioners, and the personal reflection that filled most of my hours.

There are some things that troubled me though, about the way rehab centres are set up, and trouble me still.

For one thing, the complete and total lack of personal autonomy is hard to take.  Standing in line like children for medications, for instance, and being told when you are exasperated or impatient that discipline and patience are life skills that you need to be learning is a bit much.  Discipline and patience are life skills.  Standing in line is not.  For a functioning adult and alcoholic like me, who right to the end remained in charge of her household and many other areas of her life, having freedoms like that taken away was very difficult, and something I never learned to accept.

Another challenge is the limited use of cell phones, and in the case of many centres, the forbidding of them altogether.  As a mother with a small child, I can tell you that this alone would be a deal breaker for me.  I would never accept entering an institution for thirty or sixty days when I didn’t have at least some capacity to communicate with my child, and would argue that the trauma of this total and forced separation would be so profound as to set one or both of us up for problems down the line.  While I completely understand that carrying a cell phone around all day long and texting dealers or distracting oneself from therapy on social media is obviously completely counter to the effectiveness of a treatment program, telling a spouse or parent that they cannot communicate with their families is neither fair nor reasonable, and it’s certainly not conducive to rebuilding the relationships that have been damaged by the addiction.

Yet another concern I have is the inconsistency in the messages of different counsellors regarding what works for recovery.  Either a treatment centre is 12 step, or it is not.  The centre I chose welcomed and facilitated 12 step meeting participation, but didn’t follow that model as part of its treatment protocols.  There was, however, one counsellor in particular who believed that no other kind of recovery effort would ever work, that only those who left the facility and ran, not walked to the nearest meeting, would achieve full recovery.   Contact with this counsellor since treatment has consisted of little more than being pressured to attend meetings and being told that I am not “willing to go to any lengths” for my recovery because I am not attending meetings.

Further to that, and I have written about this before, solutions for recovery need to align directly with the understanding of what causes addiction.  If addiction is understood as a spiritual malady, or the presence of a “God-sized hole”, then spiritual approaches including 12 step programs need to be utilized.  On the other hand, if addiction is understood as a physiological brain disease, affecting regions such as the limbic system and the frontal cortex, then medical and clinical interventions are appropriate.  You can’t fill God-sized holes with methadone and naltrexone, and you can’t heal a poorly-working brain by confessing to your character flaws in a church basement.

Finally, and I saw this a couple of times…It is all too easy for addiction workers to fall into the trap of cynicism and skepticism about their clientele.  Addicts do lie.  Without question.  They lie because they are engaged in criminal activity to obtain their drugs of choice, or because they want to hide their use from loved ones who are long past compassion and simply deal in judgement and shame and commands.  But addicts also tell the truth, and not just when their sorry asses are nailed to the wall, but because they know it’s the right thing to do.  Counsellors, for all their skill and patience and persistence and willingness to help, need to remember that there is good inside every addict, and that as much as anything else, their job is remind us of that.

I think a lot has been learned about addiction, but the professionals who research it and try to treat it have a long way to go.  Counselling, medication, and treatment facilities are all pieces of a huge puzzle that we are a long way from solving, and we need keen minds and caring hearts to continue to push us forward in our understanding about how to help those who suffer.

In my opinion, recovery is less about degradation and accountability then it is about healing, and forgiveness, and getting back in touch with the better angels of your nature.  It’s about remembering who you are, remembering who you used to be, and daring to believe that the future you want might just be possible.  It is, in the end, after years of wandering in the wilderness, about coming home to yourself.